Population-based controlled study of social support, self-perceived stress, activity and work issues, and access to health care in inflammatory bowel disease

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http://www3.interscience.wiley.com/cgi-bin/abstract/117882451/ABSTRACT?CRETRY=1 & SRETRY=0

Original Article

Population-based controlled study of social support, self-perceived stress, activity and work issues, and access to health care in inflammatory bowel disease

Rogala, RN 1 2, Norine , RN 1 2, Lesley A. Graff, PhD 1 3, Rawsthorne, RN 1 2, Ian Clara, MA 1 3, R. , PhD 1 3, Lix, PhD 1 4, P. Ediger, PhD 1 3, Cory McPhail, BA, 1 3, N. Bernstein, MD 1 2 *

1University of Manitoba IBD Clinical & Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada2Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada3Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada4Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

email: N. Bernstein (cbernst@...)

*Correspondence to N. Bernstein, University of Manitoba, 804F-715 McDermot Ave., Winnipeg, Manitoba R3E 3P4, CanadaThe first 2 authors participated equally.

Funded by: Canadian Institutes of Health Research Crohn's and Colitis Foundation of Canada Research Scientist Award

Keywords

quality of life • stress • social support • IBD population-based • Crohn's disease • ulcerative colitis

Abstract

Background: The Manitoba IBD Cohort Study is a longitudinal, population-based study of multiple determinants of health outcomes in persons with inflammatory bowel disease (IBD) diagnosed within 7 years at enrollment. In this cross-sectional substudy we compared IBD participants' levels of social support, self-perceived stress, disability, and access to healthcare with those of a matched community sample.

Methods: IBD participants (n = 388) were interviewed using the Canadian Community Health Surveys (CCHS) 1.1 and 1.2 to assess psychosocial variables. The national CCHS data were accessed to extract a community comparison group, matched on age, sex, and geographic residence.

Results: Compared to the community sample, IBD participants received more tangible, affective, or emotional support in the past year and were more likely to have experienced a positive social interaction. Those with IBD were as likely to be employed as those in the community sample, although they reported greater rates of reduced activity and days missed. Work was not identified as a significant source of stress, but physical health was more likely to be identified as a main stressor by those with active IBD compared to the non-IBD sample. Individuals with IBD were twice as likely to report unmet healthcare needs than the community sample; however, there was agreement across both groups regarding common barriers, including long waits and availability.

Conclusions: While the disease may contribute to greater interference with work quality and daily activities, IBD patients have similar levels of stress and appear to have enhanced social supports relative to those in the community without IBD.

(Inflamm Bowel Dis 2008)

Received: 18 June 2007; Accepted: 1 November 2007

Digital Object Identifier (DOI)10.1002/ibd.20353